Kimberly Erin Difillippo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1402 Issued in NV

Practice address

10001 S Eastern Ave
Suite 310
Henderson, NV 89052-3907

Phone

(702) 566-2400

Fax

(702) 433-2477

NPI assigned

Aug 19, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Erin Gould Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1437439544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 S EASTERN AVE",
            "address_2": "SUITE 310",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523907",
            "telephone_number": "702-566-2400",
            "fax_number": "702-433-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 S EASTERN AVE",
            "address_2": "SUITE 310",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523907",
            "telephone_number": "702-566-2400",
            "fax_number": "702-433-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFILLIPPO",
        "first_name": "KIMBERLY",
        "middle_name": "ERIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "GOULD",
            "middle_name": "ERIN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Delavante Dickerson, RBT
• Brooke Melanie Dickinson
• Shameka Dickson
• Taylor Dickson
• Elizabeth Difilippo
• Milena E Difiore
• Dignity Health
• Dignity Health
• Dignity Health
• Dignity Health Medical Group Nevada LLC

• Physician Assistant in Henderson, NV
• Providers in Henderson, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.